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Mularoni C, Servillo A, Sacconi R, Battista M, Crincoli E, Crepaldi A, Querques L, Bandello F, Querques G. 'Structural OCT changes distinguishing between myopic macular haemorrhages due to choroidal neovascularization and spontaneous Bruch's membrane rupture: the "myopic 2 binary reflective sign". Eye (Lond) 2024; 38:792-797. [PMID: 37813979 PMCID: PMC10920795 DOI: 10.1038/s41433-023-02780-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023] Open
Abstract
OBJECTIVE To evaluate the sensitivity and specificity of structural optical coherence tomography (OCT) in comparison to fluorescein angiography (FA) and OCT angiography (OCTA) in discerning between macular haemorrhages (MH) due to myopic choroidal neovascularization (m-CNV) and idiopathic macular haemorrhage (IMH) in myopic patients and to suggest a new OCT biomarker to discern these two entities. METHODS AND ANALYSIS In this longitudinal retrospective study, patients affected by MH and pathological myopia were included. All patients underwent OCTA and FA to discern bleeding from m-CNV or IMH. Furthermore, all patients underwent a structural OCT and 2 expert graders evaluated the presence of the myopic 2 binary reflective sign as a biomarker to discern between IMH and bleeding from m-CNV. RESULTS Forty-seven eyes of 47 patients were enrolled. By means of angiographic examinations, 34 out of 47 eyes with MH (57%) were diagnosed as m-CNV, whereas 13 eyes (43%) as IMH. Using structural OCT, the graders identified the presence of the myopic 2 binary reflective sign in 13 out of 13 eyes with IMH. In 33 out of 34 cases with m-CNV, the 2 graders established the absence of the sign. This accounted for 100% of sensibility and 97% of specificity of structural OCT in discerning between MH from m-CNV and IMH. CONCLUSION Structural OCT can discern with good reliability between IMH and bleeding from m-CNV based on the presence/ absence of the myopic 2 binary reflective sign. This could be of paramount relevance in the clinical setting for the diagnosis and treatment of HM patients.
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Affiliation(s)
- Cecilia Mularoni
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Andrea Servillo
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Riccardo Sacconi
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Marco Battista
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Emanuele Crincoli
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Anna Crepaldi
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Lea Querques
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Francesco Bandello
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
| | - Giuseppe Querques
- Division of Head and Neck, Ophthalmology Unit, IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy.
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Yu H, Zhong Z, Zhao Y, Luo H, Sun J, Wang R, Zhang X, Sun X. Insights into myopic choroidal neovascularization based on quantitative proteomics analysis of the aqueous humor. BMC Genomics 2023; 24:767. [PMID: 38087190 PMCID: PMC10714574 DOI: 10.1186/s12864-023-09761-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Previous studies on the biomarkers of pathologic myopia choroidal neovascularization (pmCNV) development merely detected limited types of proteins and provide a meagre illustration of the underlying pathways. Hence, a landscape of protein changes in the aqueous humor (AH) of pmCNV patients is lacking. Here, to explore the potential mechanisms and biomarkers of pmCNV, we analyzed the clinical data and protein profile among atrophic (A) lesions, tractional lesions (T) and neovascular (N) lesions in myopic patients based on the ATN grading system for myopic maculopathy (MM). RESULTS After investigating demographic data of our patients, a correlation was found between A and N lesions (R = 0.5753, P < 0.0001). Accordingly, groups were divided into patients without MM, patients with myopic atrophic maculopathy (MAM), and patients with pmCNV (N2a lesion). In proteomics analysis, the increased protein level of GFAP and complement-associated molecules in AH samples of the 3 groups also indicated that MAM and pmCNV shared similar characteristics. The GO enrichment and KEGG pathway analysis were performed, which mapped that differential expressed proteins mainly engaged in JAK-STAT pathway between the pmCNV group and two controls. Furthermore, we identified several potential biomarkers for pmCNV, including FCN3, GFAP, EGFR, SFRP3, PPP2R1A, SLIT2, and CD248. CONCLUSIONS Atrophic lesions under pathologic myopic conditions demonstrated similarities to neovascularization development. Potential biomarkers including GFAP were associated with the pathogenesis of pmCNV. In summary, our study provides new insights for further research on pmCNV development.
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Affiliation(s)
- Huimin Yu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Zheng Zhong
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China
| | - Yin Zhao
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China
| | - Huan Luo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China
| | - Jinfu Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China
| | - Ruohong Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China
| | - Xian Zhang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China.
| | - Xufang Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie-fang Road, Wuhan, Hubei Province, China.
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Victor AA, Andayani G, Djatikusumo A, Yudantha AR, Hutapea MM, Ardhia SH, Suryoadji KA. Recurrence risk of myopic choroidal neovascularisation: a systematic review of current study. BMJ Open Ophthalmol 2023; 8:e001396. [PMID: 37816549 PMCID: PMC10565155 DOI: 10.1136/bmjophth-2023-001396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
INTRODUCTION The rising prevalence of myopia is a concern in ophthalmology, with myopic choroidal neovascularisation (m-CNV) significantly affecting vision. However, long-term outcomes of m-CNV management have been unsatisfactory, leading to high recurrence rates. These studies aim to identify risk factors for m-CNV recurrence. METHODS Comprehensive review followed a pre-registered plan in the International Prospective Register of Systematic Reviews (PROSPERO). The search strategy used various databases including PubMed, Cochrane Library, Embase, Scopus and ScienceDirect using the keywords 'Myopic Choroidal Neovascularization', 'Recurrence' and 'Risk'. Eligible studies were identified and analysed based on predetermined criteria. This study was registered on PROSPERO (CRD4202343461). RESULTS The systematic review included three retrospective studies investigating risk factors associated with m-CNV recurrence. These factors are: (1) requiring three or more injections for initial disease control, (2) older age, (3) larger myopic macular neovascularisation, (4) juxtafoveal CNV, (5) larger height of hyper-reflective foci (HRF) and (6) destruction or absence of the ellipsoid zone (EZ) and retinal pigment epithelium (RPE). CONCLUSION Risk factors for m-CNV recurrence include a greater number of required injections, older age, large macular CNV, juxtafoveal location, increased HRF height and changes in EZ and RPE structure. Understanding these factors can inform personalised treatment approaches and improve patient outcomes by identifying individuals at higher risk of recurrence and implementing proactive measures to mitigate the impact of m-CNV recurrence and progression. Further investigation is needed to enhance our understanding of the underlying mechanisms and develop innovative therapeutic approaches for effective m-CNV management. PROSPERO REGISTRATION NUMBER CRD4202343461.
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Affiliation(s)
- Andi Arus Victor
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Gitalisa Andayani
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Ari Djatikusumo
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Anggun Rama Yudantha
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Mario Marbungaran Hutapea
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Seruni Hanna Ardhia
- Research Assistant, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Borrelli E, Berni A, Mastropasqua L, Querques G, Sadda SR, Sarraf D, Bandello F. Pushing Retinal Imaging Forward: Innovations and Their Clinical Meaning - The 2022 Ophthalmologica Lecture. Ophthalmologica 2023; 246:278-294. [PMID: 37703839 DOI: 10.1159/000533910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/27/2023] [Indexed: 09/15/2023]
Abstract
Retinal imaging has greatly expanded our understanding of various pathological conditions. This article presents a summary of the key points covered during the 2022 Ophthalmologica Lecture held at the Euretina Congress in Hamburg. The first part of the article focuses on the use of optical coherence tomography angiography to examine and comprehend the choroid in age-related macular degeneration (AMD). Subsequently, we delve into the discussion of the "postreceptor neuronal loss" theory in AMD, which was studied using en face structural optical coherence tomography (OCT). Following that, we explore pertinent findings obtained through cross-sectional OCT in retinal and optic nerve diseases, such as AMD, diabetic macular edema, pathologic myopia, central serous chorioretinopathy, and Leber's hereditary optic neuropathy.
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Affiliation(s)
- Enrico Borrelli
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Berni
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Leonardo Mastropasqua
- Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giuseppe Querques
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Srinivas R Sadda
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, USA
| | - David Sarraf
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Ophthalmology, David Geffen School of Medicine at UCLA, Stein Eye Institute, Los Angeles, California, USA
| | - Francesco Bandello
- Vita-Salute San Raffaele University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
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